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Is Your Loved One Suffering From Dementia?

Learn about the various types of dementia, how doctors diagnose it, and how to get help if you suspect your loved one is suffering from dementia.

By
Sanaz Majd, MD,
September 5, 2013
Episode #131

Page 2 of 2

...patients have difficulty handling basic activities of daily living, such as getting dressed and eating, and eventually difficulties with toileting.  They also eventually develop difficulty remembering people, even important ones in their lives.  This more than anything leads to the greatest amount of heartbreak for family members, as you can imagine.

Various Types of Dementia

Alzheimer's is by far the most common type of dementia and does have a hereditary component.  However, there are a few other types of dementia we see in patients:

  • Vascular Dementia:  Comprises about 10% to 20% of dementia cases and is caused by plaque build-up in the vessels of the brain. This is more common in those with a history of heart disease or stroke.
  • Lewy Body Dementia:  Specific protein deposits in the brain called "Lewy Bodies" are found. They're the key defining feature of this type of dementia. Visual hallucinations are more common than in Alzheimer's.
  • Parkinson’s Dementia:  Occurs in those with a history of Parkinson’s disease. It often progresses more rapidly than Alzheimer’s.
  • Alcoholic Dementia:  More prevalent in patients with a history of heavy alcohol intake and/or alcoholism.
  • Frontal Lobe Dementia: Imaging studies may show most changes in the frontal lobe of the brain, where personality is most affected.  

How to Diagnose Dementia

It’s also important to rule out other potential medical conditions that can mimic dementia.

There are various ways to screen for dementia, however, most doctors use something called a “Mini-Mental State Examination,” which comprises of 30 questions and can be found on the internet to administer to your family members if you choose to.  The major issue with this test is education level – those who have a lower education level may score lower than they otherwise would, and those with higher education levels can score higher than they really should. 

There is also a special “clock drawing test” that assesses organization and planning and can also be found online.  Experts don’t agree on how to score it, however.  Therefore, it’s either often considered “normal” when drawn exactly or “abnormal” if not.

It’s also important to rule out other potential medical conditions that can mimic dementia, such as thyroid disorder, vitamin B12 deficiencies, HIV, syphilis, stroke, depression, alcoholism, and infection.  Your doctor may also order a blood test and possibly a CT scan of the brain as part of the testing, although the CT is a low-yield test for most patients.

Where to Go for More Information

Obviously, your first source of information should be your primary care doctor.  Be prepared to give exact examples of your loved one’s behavior changes when first discussing this topic with your doctor. Consider these questions:

  • Are they able to balance their checkbook?
  • Do they ask the same questions repeatedly?
  • Are they getting lost driving to places they’ve been to numerous times?
  • Are they having trouble with complex activities they used to enjoy, such as cooking or knitting?
  • Are they leaving the stove on?
  • Are they using a shoe as a telephone?
  • Are they forgetting where they live? The date? Familiar names?
  • Are they hallucinating or hearing voices?
  • Are they depressed?
  • Are their symptoms sudden in onset, or gradual over time?

If your primary care doctor suspects a problem, they can refer you to see a neurologist.  There are medications that may slow the disease's progression, however, nothing can reverse it, unfortunately. 

Resources

http://www.nlm.nih.gov/medlineplus/alzheimersdisease.html

http://www.nlm.nih.gov/medlineplus/ency/article/000739.htm

http://www.alzheimers.gov

http://www.alz.org/

www.cdc.gov/Features/Alzheimers

What are your thoughts on this issue?  Share it with us on the House Call Doctor’s Facebook and Twitter pages!

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

Don't forget image courtesy of Shutterstock.

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